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Research
The above are the main medical disorders that have been covered in research. You can visit PubMed for more details. Arthritis This article is not available through PubMed. The citation below does not indicate the journal of publication. The abstract below does not state the actual placebo used. A valid placebo would have to have been an identical device emitting light and heat to the same degree as the Q1000, otherwise the placebo would be an invalid comparison. Could the original author please supply the location of this article? And hopefully the full article, or at least a quotation regarding the actual placebo used. The Q1000 is FDA Cleared for Osteoarthritis of the Hand. The Effects of Low Level Laser Therapy on Osteoarthritis (OA) of the Hand: A Clinical Study Dr Larry Lytle, DDS, Ph.D. and Dr. Serafettin Ozdogan, MD ABSTRACT Objective: The objective of this placebo controlled, randomized, double blind, parallel group designed clinical study was to determine the effectiveness and feasibility of over-the-counter (OTC) use of the Q Laser System, made up of the Q1000 low level laser, a multiple diode device and the 660 nm enhancer laser probe, in providing temporary relief of pain and stiffness arising from osteoarthritis of the hand, when the treatment is administered by an individual in his or her own home. Background: Studies have shown that low level laser therapy is beneficial for treating the pain and stiffness associated with osteoarthritis when treated in medical offices 6,7,8,9,10,but there are few studies demonstrating the relief of osteoarthritis symptoms using low level laser therapy when the individual treats themselves at home. Methods and Materials To qualify for the study subjects had to be diagnosed with osteoarthritis of one hand by criteria set by the American College of Rheumatology. Ninety one subjects, forty six in a placebo group and forty five in an active laser group treated themselves five times every other day for 10 days for one minute each on selected proprioceptive points using the multiple diode instrument and for 30 seconds on selected acupoints and direct on the affected joints using a single diode instrument. The laser system utilized (Q Laser System manufactured by 2035 Inc) was composed of two instruments, one, a hand held DC powered laser containing eight LEDs and twelve 5 mW laser diodes arranged to form 6 direct soliton waves and 32 indirect soliton waves, emitting 2.5 J/cm² of energy to an area 1.0322 cm2 covering an area of 45.7 mm in diameter. The other instrument used was a single diode 50 mW continuous beam enhancer probe operated at 35 mW emitting 2.16 J/cm² to an area 0.2826 cm2 covering an area of 6 mm in diameter. Results: ROM evaluations demonstrated 87% improvement in range of motion over the placebo group and 87% of the subjects reported at least a 30% improvement in pain as measured by the VAS scale by the end of active treatment at day 10 with continuing latent benefits of reduction of pain and improvement of range of motion at days 21 and 32. The placebo group used twice as much Tylenol, the rescue pain medication designated for this study, as did the laser treated group and 81% of the treated group were satisfied with the laser system and 95% of all subjects stated the operations and instruction manual was easy to follow and they were very confident they followed the treatment protocol. Conclusion: Based on the results of this study it can be concluded that the protocol used with this combination of low level lasers provided substantial relief of osteoarthritis symptoms when used by the patient in their own home and the instruments were easy to use. Asthma Treatment of bronchial asthma with low-level laser in attack-free period at children Ailioaie, C.; Ailioaie, Laura AA(Univ. of Medicine and Pharmacy) Proc. SPIE Vol. 4166, p. 303-308, Laser Florence '99: A Window on the Laser Medicine World, Leonardo Longo; Alfons G. Hofstetter; Mihail L. Pascu; Wilhelm R. Waidelich; Eds. (SPIE Homepage) 06/2000 SPIE © 2000 SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only. 2000SPIE.4166..303A Abstract Bronchial asthma is a common disease in both the pediatric and adult populations, characterized by wide variations over short periods of time in resistance to airflow in intrapulmonary airways. A primary goal in the use of low- level laser therapy (LLLT) was the safe, effective and rapid palliation of symptoms owing to tracheal or bronchial obstruction. We have investigated the effects of LLLT comparatively with other modality trials in children's asthma. In the study were included 98 patients aged 10-18 years diagnosed with moderate or severe asthma, in attack- free period. The patients were divided into 3 groups. Group 1 received only laser therapy using extra meridian acupuncture points and scanning technique. Group 2 was treated only with inhaled Serevent 2 X 25 micrometers , two times daily, 3 months. Group 3 was tread with Theophylline retard in dosage of 15-mg/kg/12 h, 3 months. At the end of treatment we remarked a noticeable improvement of the clinical, functional and immunological characteristics at 83 percent of patients in group 1, comparatively with only 70 percent (group 2) and 53 percent (group 3). The LLLT had a very good action on bronchial patency , displayed an immunocorrecting action and is recommended in attack-free periods at children. Allergic Rhinitis Neuman & Finkelstein studied 50 patients in a double-blind randomized study. Following treatment with a 660 nm red laser 72% of the treatment group reported improvement of symptoms as compared to 24% of the placebo group. Ann Allergy Asthma Immunol 1997;78:399-406 Bacterial Infection …in research led by Michael Hamblin of Mass. Gen. Hospital and Harvard Medical School, mice with surgically induced wounds were dosed with bioluminescent bacteria to create potentially lethal infections. Utilizing a 665 nm laser diode photodynamic therapy (soft laser therapy) the researchers found that “infected wounds healed significantly faster with the PDT method. PDT shows promise as a topical antimicrobial alternative that may work even faster than antibiotics.” The Journal of Infectious Diseases, June 1, 2003, PP 1717-1725. Blood Pressure Dr. Umeda tested the effects of a soft laser on the control of blood pressure via energy administered to the medulla oblongata. The results from a group of 30 patients suffering from hypertension were positive in 80% of the cases.Laser Therapy. 1990; 2(2): 59 Cancer The latest research on LLLT and cancer. Carpal Tunnel Syndrome Soft laser therapy has been approved by the FDA as an adjunct treatment method for this condition. Diabetes Mellitus Click here for full case study. Epicondylitis (Tennis Elbow) Dr. Simunovic treated 324 patients . . . complete pain relief and restored functional ability were achieved in 82% of the acute patients and 66% of the chronic cases. wJ Clin Laser Med & Surg. 1998; 16 (3): 145-151 Fibromyalgia Efficacy of low power laser therapy in fibromyalgia: a single-blind, placebo-controlled trial. *Low energy lasers are widely used to treat a variety of musculoskeletal conditions including fibromyalgia, despite the lack of scientific evidence to support its efficacy. A randomised, single-blind, placebo-controlled study was conducted to evaluate the efficacy of low-energy laser therapy in 40 female patients with fibromyalgia. Patients with fibromyalgia were randomly allocated to active (Ga-As) laser or placebo laser treatment daily for two weeks except weekends. Both the laser and placebo laser groups were evaluated for the improvement in pain, number of tender points, skinfold tenderness, stiffness, sleep disturbance, fatigue, and muscular spasm. In both groups, significant improvements were achieved in all parameters (p0.05). It was found that there was no significant difference between the two groups with respect to all parameters before therapy whereas a significant difference was observed in parameters as pain, muscle spasm, morning stiffness and tender point numbers in favour of laser group after therapy (p<0.05). None of the participants reported any side effects. Our study suggests that laser therapy is effective on pain, muscle spasm, morning stiffness, and total tender point number in fibromyalgia and suggests that this therapy method is a safe and effective way of treatment in the cases with fibromyalgia. Lasers Med Sci. 2002;17(1):57-61. Gur A, Karakoc M, Nas K, Cevik R, Sarac J, Demir E. Physical Medicine and Rehabilitation, School of Medicine, Dicle University, Diyarbakir, Turkey. *Longo treated 846 patients with fibromyositic rheumatism during a 15 year period. About 2/3 benefited from the treatment with regard to local pain, hypomobility and phlogosis. J Clin Laser Med Surg. 1997; 15 (5): 217-220 Headache/Migraine Wong treated 20 patients with migraine or symptoms resembling migraine. The pain disappeared after 1-5 minutes. Proc 9th Congress Soc Laser Surgery and Medicine, Anaheim, CA: 2-6 Nov. 1991 Pain *SPIE.org studies on pain and LLLT research.. *'Chronic Neck Pain' There is now more evidence for the use of laser for neck pain than any other medical procedure. The Lancet report says “(Relief using) Laser for neck pain lasted for up to 22 weeks.Trials of LLLT for knee osteoarthritis tendinopathies and low back pain reported similar results”. “This contrasts with drug therapies where the effect ends rapidly when treatment is discontinued.” The BMJ agrees “There isn’t any specific research that shows drugs help neck pain”. *'Low Back Pain ' Dr. Soriano performed a double-blind trial with elderly people suffering from chronic low back pain. Treatment was effective in 71% of the laser group and 36% of the sham group. The pain disappeared completely in 45% of the laser group and 15% of the sham group. Lasers Surg Med. 1998 Suppl 10, p.6 *'Shoulder Pain ' Soft laser therapy has been approved by the FDA as an adjunct treatment method for pain related to shoulder injuries. Parkinsons Several significant studies on the benfits of using LLLT with parkinson's disease.. Rheumatism/Osteoarthritis Dr. Palmgren conducted a controlled double-blind study on 35 patients with rheumatoid arthritis of the hand. In the experimental group, grip strength and movement were improved while swelling, pain and morning stiffness were reduced. Lasers in Medical Science, 1989; 4: 193. Wound Healing Dr. Palmgren investigated the effect of soft laser therapy on infected abdominal wounds after surgery. Healing time to half wound size was 6.8 days in the laser group compared to 14 days in the placebo group. Lasers Surg Med 1991; Suppl 3:11 Research Articles (not categorized yet, use Search window on left) Other Studies Biphasic Dose Response in Low Level Light Therapy (A meta-analysis of research) Ying-Ying Huang, Aaron C.-H. Chen, James D. Carroll, Michael R. Hamblin International Dose-Response Society The use of low levels of visible or near infrared light for reducing pain, inflammation and edema, promoting healing of wounds, deeper tissues and nerves, and preventing cell death and tissue damage has been known for over forty years since the invention of lasers. Despite many reports of positive findings from experiments conducted in vitro, in animal models and in randomized controlled clinical trials, LLLT remains controversial in mainstream medicine. The biochemical mechanisms underlying the positive effects are incompletely understood, and the complexity of rationally choosing amongst a large number of illumination parameters such as wavelength, fluence, power density, pulse structure and treatment timing has led to the publication of a number of negative studies as well as many positive ones. A biphasic dose response has been frequently observed where low levels of light have a much better effect on stimulating and repairing tissues than higher levels of light. The so-called Arndt-Schulz curve is frequently used to describe this biphasic dose response. This review will cover the molecular and cellular mechanisms in LLLT, and describe some of our recent results in vitro and in vivo that provide scientific explanations for this biphasic dose response. Treatment of repetitive use carpal tunnel syndrome Smith CF, Vangsness CT, Anderson T & Good W (1995) Proceedings SPIE (1995) 2395; 658-661. A randomized, double-blind study was initiated in 1990 to evaluate an eight-point conservative treatment program in carpal tunnel syndrome. 160 patients were delineated with symptoms of carpal tunnel syndrome and these patients were then divided into two groups. Both groups were subjected to an ergonomically correct eight-point work modification program. A counterfeit LLLT unit was used in Group A, while an actual LLLT unit was used in Group B. Groups A and B were statistically significantly different in terms of return to work, conduction study improvement, and certain range of motion. Noninvasive laser neurolysis in carpal tunnel syndrome Weintraub MI, MD, FACP Muscle Nerve (1997) 20:1029-1031. The peripheral nervous system is photosensitive, the scientific rationale for this study which determines the efficacy and safety to laser light exposure in 30 cases with CTS. Nine joules of energy over 5 points (7-15 treatments) reversed CTS in 77% of cases with three-fold normalization of CMAP. A photobiologic response was seen in 80%. This unique and novel approach is cost-effective and has a role in future management of CTS. Treatment of medial and lateral epicondylitis - tennis and golfer's elbow - with LLLT: a multicenter double blind, placebo-controlled clinical study on 324 patients. Simunovic Z, Trobonjaca T, Trobonjaca Z Journal of Clinical Laser Medicine and Surgery (Jun 1998) 16(3):145-151. LLLT has been promoted as a highly successful method for treating medial and lateral epicondylitis. This clinical study assessed the efficacy of LLLT using trigger points (TPs) and scanner application techniques under placebo-controlled conditions. The study was completed at two Laser Centers in Locarno, Switzerland and Opatija, Croatia: a double-blind, placebo controlled, crossover clinical study. The patient population (n=324), with either medial epicondylitis (Golfer's elbow; n=50) or lateral epicondylitis (Tennis elbow; n=274), was recruited. Unilateral cases of either type of epicondylitis (n=283) were randomly allocated to one of three treatment groups according to the LLLT technique applied: (1) Trigger points; (2) Scanner; (3) Combination Treatment (i.e., TPs and scanner technique). Laser devices used to perform these treatments were infrared (IR) diode laser (GaAIAs) 830 nm continuous wave for treatment of TPs and He-Ne 632.8 nm combined with IR diode laser 904 nm, pulsed wave for scanner technique. Energy doses were controlled and measured in Joules/cm2 either during TPs or scanner technique sessions in all groups of patients. The treatment outcome (pain relief and functional ability) was observed and measured according to the following methods: (1) short form of McGill's Pain Questionnaire (SF-MPQ); (2) visual analogue scales (VAS); (3) verbal rating scales (VRS); (4) patient's pain diary; and (5) hand dynamometer. Total relief of the pain with consequently improved functional ability was achieved in 82% of acute and 66% of chronic cases. Best results were obtained by a combination treatment (i.e., TPs and scanner technique). Under-and over irradiation dosage result in the absence of positive therapy effects or even opposite, negative (e.g., inhibitory) effects. The data shows the efficacy of LLLT in the management of lateral and medial epicondylitis. Wound healing of animal and human body sport and traffic accident injuries using low-level therapy treatment; a randomized clinical study of seventy-four patients with control group.' '''Simunovic Z, Ivankovich AD, Depolo A. Journal of Clinical Laser Medicine and Surgery (2000) Apr;18(2):67-73 The main objective was to assess the efficacy of low level laser therapy (LLLT) on wound healing in rabbits and humans. The initial research was a randomized controlled animal study, to evaluate the effects of laser irradiation on the healing of surgical wounds in rabbits. The application of LLLT on the human body is analogous to those of similar physiologic structure in animal tissue. This study was continued on humans, 74 patients with injuries to the following anatomic locations: ankle and knee, bilaterally, Achilles tendon; epicondylitis; shoulder; wrist; interphalangeal joints of hands, unilaterally. All patients has surgery prior to LLLT. Two laser devices were used: infrared diode laser (GaAIAs) 830 nm continuous wave for treatment of trigger points (TPs) and HeNe 632.8 nm combined with diode laser 904 nm pulsed wave for scanning procedure. Both were applied as monotherapy during the study. Results were observed and measured according to these clinical parameters: redness, heat, pain, swelling and loss of function, and finally submitted to statistical analysis via chi2 test. Results: After comparing the healing process between two groups of patients, the following results were noted: wound healing was significantly accelerated (25%-35%) in the patients treated with LLLT. Pain relief and functional recovery of those treated with LLLT were significantly improved compared to untreated patients. In addition to accelerated wound healing, LLLT for postoperative sport-and traffic-related injuries avoids side effects of drugs, accelerates functional recovery, allows earlier return to work, training and sport competition. '''LLLT with trigger points technique: clinical study on 243 patients' Simunovic Z Journal of Clinical Laser Medicine and Surgery (Aug. 1996) 14(4):163-167. Among the various methods of application techniques in LLLT (He-Ne 632.8 nm visible red or infrared 820-830 nm continuous wave and 904 nm pulsed emission) there are very promising "trigger points", i.e., myofascial zones of particular sensibility and of highest projection of focal pain points, due to ischemic conditions. The effect of LLT and the results obtained after clinical treatment of >200 patients (headaches and facial pain, skeletomuscular ailments, myogenic neck pain, shoulder and arm pain, epicondylitis, tenosynovitis, low back and radicular pain, Achilles tendonitis) to whom the "trigger points" were applied were better than expected. It was also observed that rigidity decreases, mobility is restored (functional recovery), and spontaneous or induced pain decreases or even disappears, by movement. LLLT improves local microcirculation and it can also improve oxygen supply to hypoxic cells in the treated areas and can remove collected waste products. Normalization of the microcirculation interrupts the "circulus vitiosus" of the origin of the pain and its development (Melzak: muscular tension->pain->increased tension->increased pain, etc.). Results measured according to VAS/VRS/PTM: in acute pain, diminished >70%; in chronic pain >60%. Clinical effectiveness depends on correctly applied energy dose - over/under dosage produces opposite, negative effects on cellular metabolism. No negative effects were noted and the use of analgesic drugs could be reduced or completely excluded. LLLT may be used as monotherapy or as a supplement to other therapeutic procedures for pain treatment. Laser-Accelerated INFLAMMATION/PAIN REDUCTION AND HEALING by Richard Martin, BS, CLT Practical Pain Management, Nov/Dec 2003 Injured cells and tissues have greater affinity for LLLT than healthy cells and tissues. LLLT in the treatment of inflammation, pain and healing is a highly integrated process, but the author separates those processes categorically for identification. Acute Inflammation Reduction (flowchart provided in the original article) - After injury, tissues initiate a series of biological responses and cellular membrane reactions which manifest in a combination of edema, inflammation, pain and functional debility. LLLT mediates by: (1) Stabilizing cellular membranes; (2) Enhancing molecule ATP production and synthesis; (3) Stimulating vasodilation via increased Histamine, Nitric Oxide and Serotonin; (4) Accelerating leukocytic activity; (5) Increasing Prostaglandin synthesis; (6) Reducing Interleukin-1; (7) Enhancing lymphocyte response; (8) Increasing angiogenesis; (9) Modulation temperature; (10) Enhancing superoxide dismutase levels; and (11) Decreasing C-reactive protein and neopterin levels. Pain Reduction (flowchart provided in the original article) - Evidence justifies a conclusion that LLLT reduces pain by combination of processes: (1) Increase in b-Endorphins; (2) Blocked depolarization of C-fiber afferent nerves; (3) Increased nitric oxide production; (4) Increased nerve cell action potential; (5) Axonal sprouting and nerve cell regeneration; (6) Decreased Bradykinin levels; (7) Increased release of acetylcholine; and (8) Ion channel normalization. Tissue Healing - LLLT enhances wound healing by: (1) Enhanced leukocyte infiltration; (2) Increased macrophage activity; (3) Increased neovascularization; (4) Increased fibroblast proliferation; (5) Keratinocyte proliferation; (6) Early epithelialization; (7) Growth factor increases; (8) Enhanced cell proliferation and differentiation, and (9) Greater healed wound tensile strength. Laser and Sports Medicine in Plastic and Reconstructive Surgery. Junichiro Kubota M.D. Department of Plastic and Reconstructive Surgery, Kyorin University School of Medicine, Tokyo, Japan. Flap survival with diode laser therapy: Skin flap or graft surgery are major procedures in plastic and reconstructive surgery. Skin flap necrosis has been a problem. The author reported on the enhanced blood flow following the low reactive laser therapy in skin flaps. The 830 nm diode laser (20 - 60 mw) irradiated flaps showed a greater perfusion, a greater number of blood vessels, and a higher rate of survival areas than the control flaps in the rat models and clinical cases. Improvement of wound healing with diode laser therapy: Diode laser therapy was indicated for traumatic skin ulcers from sport activities and traffic accidents which were resistant to conservative treatment. The diode laser system with a wavelength of 830 nm. and output power of 150or 1000mw in continuous wave was applied with the non-contact method to the area on the wound for one minute once a day every day during the treatment period. The diode laser was used successfully for the rapid enhanced healing of traumatic skin ulcers. Discussion: Most injured patients hope to avoid a surgical operation, trying instead conservative treatments. The diode laser therapy improved the flap circulation and wound healing of severe skin ulcers. This therapy has been applied for temporomandibular joint pain and favorable results were obtained. The diode laser therapy proved to be particularly effective for pain attenuation. The diode laser therapy offers an additional convenient, safe, and side-effect free method. On the other hand, the Q-switched Nd:YAG laser system consistently achieved good results concomitant with easy and safe operation, with lightening of the target lesions. BIOMODULATORY EFFECTS OF LLLT ON BONE REGENERATION Antonio L.B. Pinheiro1 et al. School of Dentistry, Department of Diagnostic and Therapeutics, Universidade Federal da Bahia, Salvador, BA, 40110-150,Brazil; 2 School of Dentistry Low Level Laser Therapy (LLLT) for wound healing is effective in modulating both local and systemic response. Usually the healing process of bone is slower than that of soft tissue. Effects of LLLT on bone are still controversial. This paper reports observations on the effect of LLLT on bone healing. The amount of newly formed bone after 830nm laser irradiation of surgical wounds created in the femur of rats was evaluated morphometricaly. Forty Wistar rats were divided into four groups: group A (12 sessions, 4.8J/cm2 per session, 28 days); group C (three sessions, 4.8J/cm2 per session, seven days). Groups B and D acted as non-irradiated controls. Forty-eight hours after the surgery, the defects of the laser groups were irradiated transcutaneously with a CW 40mW 830nm diode laser, (f~1mm) with a total dose of 4.8J/cm2. Irradiation was performed three times a week. Computerized morphometry showed a significant difference between the areas of mineralized bone in groups C and D (p=0.017). There was no significant difference between groups A and B (28 days) (p=0.383). In a second investigation, the effects of LLLT on bone healing after the insertion of implants were determined. Dental implants need four and six months for fixation on the maxillae and on the mandible before loading. Ten male and female dogs were divided into two groups of five animals that received the implant. Two animals of each group were controls. Animals were sacrificed 45 and 60 days after surgery. The animals were irradiated three times a week for two weeks in a contact mode with a CW 40mW 830nm diode laser, (f ~1mm) with a total dose per session of 4.8J/cm2 and a dose per point of 1.2J/cm2. Better bone healing after irradiation with the 830nm diode laser were shown from the SEM study, suggesting that, under experimental conditions of the investigation, LLLT at 830nm significantly improves bone healing at early stages. and may increase bone repair at early stages of healing. THE USE OF LASER THERAPY AND ADDITIONAL THERAPEUTIC MODALITIES AFTER ARTHROSCOPY OF THE KNEE AT ALPINE SKI TEAM Lilic Alen, physiotherapist; 2Kozlevcar _ivec Maja, dr. med. spec.fiz.reh.med.; 3Marcan Radoslav, dr.med., spec.ortop 1FIZIO, Ilirska Bistrica, Slovenija, 2Iskra Medical, Ljubljana, Slovenija, 3Ortopedska bolni_nica Valdoltra, Slovenija. We review different kinds of injuries in the alpine ski sport concentrate on the injuries of the ligamentar part of the knees and meniscs in slovenian ski team. After the description of the injuries is a detailed presentation of the rehabilitational procedures from the first day of the injury till the return in to the competition arena. We explain the modalities of the rehabilitational procedures and their influence in the tissues, their main and side effects. Our main attention is focused on the use of the biostimulative lasers of higher power - 1,2 W and wavelength of 830 nm and their influence speedy recovery of the patients and their success in later competitions. Laser's effect on bone and cartilage change induced by joint immobilization: an experiment with animal model. Akai M, Usuba M, Maeshima T, Shirasaki Y, Yasuoka S Lasers Surg Med. 1997. 21(5): 480-4. The influence of low-level (810 nm) laser on bone and cartilage during joint immobilization was examined. The hind limbs of 42 young Wistar rats were immobilized at the knee joint. They were sorted into three groups 1 wk after operation; irradiance 3.9 W/cm2, 5.8 W/cm2, and sham treatment. After 6 treatments for another 2 weeks both hind legs were prepared for 1) indentation of the articular surface of the knee (stiffness and loss tangent), and for 2) dual energy X-ray absorptiometry (bone mineral density) of the focused regions. The indentation test revealed preservation of articular cartilage stiffness with 3.9 and 5.8 W/cm2 therapy. Low level laser treatment may possibly prevent biomechanical changes by immobilization. Low- and High-Intensity Lasers in the Treatment of Herpes Simplex Virus 1 Infection Marina Stella Bello-Silva et al. Photomedicine and Laser Surgery. More Positive Double Blind Low Level Laser Therapy (LLLT) Studies